PurposeOral carcinoma cuniculatum is a rare well-differentiated variant of oral squamous cell carcinoma. The purpose was to systematically review its unique features to differentiate it from other variants as verrucous carcinoma, papillary squamous cell carcinoma and well-differentiated squamous cell carcinoma.Materials and MethodsA systematic review was performed using MEDLINE, Dentistry and Oral Sciences Source and PubMed databases and any existing articles related to the research subject missed in the search strategy to screen ones reporting cases occurring exclusively in the oral cavity in English literature. Variables analyzed included clinical, etiologic, imaging, histopatholgical features, treatment, follow-up and survival rates.ResultsFrom 229 hits, 17 articles with 43 cases were included in the systematic review. Clinically it showed a female predilection with pain and/or ulceration of a relatively long duration and exudation being the most common symptoms. Histologically, it showed more endophytic features comprising well-differentiated squamous epithelium with absent or minimal cytological atypia and multiple keratin filled crypts or cuniculus. Inflammatory stromal reaction and discharging abscesses were reported in most of the cases. Bone destruction was predominant in most imaging features. Complete surgical resection with a safety margin was the treatment of choice in most of the cases with few recorded recurrence cases.ConclusionApprehensive knowledge of oral carcinoma cuniculatum unique features is essential to avoid its misdiagnosis and provide proper treatment especially for recurrent cases.

Background and Aim: Oral squamous cell carcinoma is by far one of the most common oral cancers. The success of early detection of cancer using recent modalities such as collected human saliva can guarantee a high success rate of treatment. This study aimed to investigate the expression of microRNAs and interleukins in exosomes as potential salivary biomarkers and to evaluate their accuracy in early detection of oral cancer. Material and methods: Samples of saliva were collected from 37 patients divided into 6 healthy control, 17 smokers and 14 patients with different grades of oral squamous carcinoma. Exosomes were isolated from 3 ml saliva using ultracentrifugation protocol and were prepared for electron microscopy characterization. Expression of microRNA-200a and microRNA-134 was analyzed by qRT-PCR. IL-1β and IL-8 concentrations were also assessed in isolated salivary exosomes. All data array of salivary isolated tested biomarkers was represented as mean values and standard deviation. Results: Concentrations of both salivary IL-1β & IL-8 demonstrated a highly significant increase in cancer patients compared to smoker and control groups (p≤0.00001). Additionally, microRNA-200a and microRNA-134 were upregulated and revealed a highly significant increase in cancer patients in comparison to other groups (p≤0.00001). No significant changes were observed between different grades of oral squamous cell carcinoma. Conclusion: Isolated salivary exosomes provide a stable and non-invasive route for evaluation of different salivary biomarkers which can be a useful tool in early detection of oral cancer.

Background: Oral squamous cell carcinoma is occupying the eighth position of all malignant neoplasia worldwide. Nowadays, natural compounds found in vegetables and fruits are important resources of many anticancer drugs especially those with high levels of phytochemicals representing an efficient strategy for cancer prevention and treatment. Artichoke (Cynara cardunculus L.) is a kind of antioxidant-rich vegetables demonstrated a potential anticancer activity on various types of cancer cells related to its content of phenolic compounds. Anticarcinogenic effects of polyphenolic extracts were reported to cause a reduction in cell viability, inhibition of cell growth, and initiation of apoptotic mechanisms. The present study aimed to investigate the cell cycle arrest, cytotoxic, and apoptotic effects of artichoke extract against the invasive oral squamous cell carcinoma. Results: A pure extract from the edible part and leaves of fresh artichoke was added to oral squamous carcinoma cell lines and to control group to evaluate the expression of caspase-9, Bcl-2, and Bax genes. Artichoke extract demonstrated the highest cytotoxic effect against cancer cell lines which increased in a time-dependent manner. No apparent effects were observed in the normal control group. Expression of Bax and caspase-9 genes revealed a highly significant increase in cancer cell lines (p = 0.0001) when compared to the control group. In addition to a highly significant decrease (p = 0.005) in Bcl-2 of cancer cells. It was demonstrated that artichoke extract induced cell growth arrest at G2/M phase which revealed a significant increase (p < 0.05) in comparison to the untreated control group. Conclusion: Artichoke exerts potent cell cycle arrest, cytotoxic, and apoptotic effects on oral squamous carcinoma cell lines.

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Background and Aim: Incorporation of Montmorillonite (MMT) nanoclay in restorative materials improves their mechanical properties in addition to biocompatibility, yet little is known about effects of MMT nanoclay-modified glass ionomer on dental pulp. This study aimed to evaluate pulp response of MMT nanoclay-modified glass ionomer as viable biocompatible material compared to resin-modified and conventional in dog model. Material and methods:MMT nanoclay was characterized using X-ray Diffraction (XRD) and Fourier Transform Infra-Red Spectroscopy (FTIR). Class V cavities were prepared in 90 dogs' teeth and divided into 3 groups (n=30): G1: conventional, G2: MMT nanoclay-modified, and G3: resinmodified glass ionomer. Then the jaws were dissected and demineralized at three-time intervals of 7, 30 and 60 days to evaluate the pulp response of the extracted teeth of each group microscopically and statistically using Kruskal Wallis and Friedman tests.Results: MMT nanoclay-modified glass ionomer (G2) group at 7 days was associated with reduced signs of inflammation with lesser interstitial edema, marked thickening of collagen fibers, mild inflammatory cell infiltrate and less destruction of the odontoblastic layer compared to the other two groups. Further healing was observed with nanoclay group after 30 days with significantly reduced inflammation and promoted regeneration of the odontoblastic layer and pulp tissue to reach a normal histological pulp architecture by 60 days. Conclusion:MMT nanoclay-modified glass ionomer is a promising biocompatible material that shows favourable pulp response over both conventional and resin-modified.

Background and Aim: Odontogenic tumors are heterogeneous group of lesions originating from odontogenic apparatus and their remnants. Although their etiopathogenesis remains unclear, some advances have been accomplished in understanding the role of their enamel-related proteins. Amelogenin is the major structural enamel matrix protein involved in the development of odontogenic epithelium. Osteopontin is a multifunctional biomarker that affects cell survival, migration, calcification inhibition, and immune cell function modulation. The study aimed to assess the immunoexpression of both biomarkers in different odontogenic lesions.Material and Methods: Forty-eight paraffin-embedded blocks of odontogenic tumors and cysts were involved including multicystic ameloblastoma (n=10), unicystic ameloblastoma (n=9), dentigerous cyst (n=11), odontogenic keratocysts (n=7), and radicular cyst (n=8). Quantitative immunohistochemical analysis for amelogenin and osteopontin were recorded with index of positivity. The results were statistically analyzed using Kruskal-Wallis test and Spearman's coefficient rank correlation analysis. Results:Positive immunoreaction for amelogenin was demonstrated in both control and dentigerous cyst groups while unnoticeable expression was detected in other studied groups. Regarding osteopontin, positivity was detected in ameloblastomas and some examined cysts. Highly statistically significant differences between both biomarkers were revealed in all tested groups (p < 0.001). Spearman's rank analysis reported negative correlation between both biomarkers with highly significant values (p < 0.0001). Conclusion:Amelogenin can be a promising predictor for the biological behavior of odontogenic lesions and pro-invasive factor osteopontin can predict neoplastic potential and high probability of recurrence.

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